Search PubMed⌕ Search

Biomedical subjects

T Junginger

Publications and source records attributed to T Junginger.

At least 253 records · Page 14Linked to original sources
PubMed1991

[Animal experiment studies of pedicled small intestine transplantation as partial extrahepatic bile duct replacement].

A pedicle graft of the jejunum can in some cases enlarge a bile duct stricture. The enlargement of the patch and its consequences on the liver function are possible problems. In an animal experiment the following questions were sought. 1) Is a partial replacement of the bile duct with a pedicle graft of small bowel possible? 2) Is there an enlargement of the patch in every case and what are the consequences on the biliary tract and on liver function. The experiments were performed on 14 minipigs over a long-term observation period of 450 days. The red and white blood cell count, the GPT, GOT, GPT, bilirubin and alkaline phosphatase and copper were checked monthly. After 2, 6 and 12 months the intra- and extrahepatic biliary tract were visualized via a PTC. After 8 months an angiography of the pedicle graft was performed. 15 months later the animals were killed and the bile duct, the graft and the liver were histologically examined. 1) With a pedicle graft of small bowel a partial replacement of the extrahepatic bile duct is possible. 2) An enlargement of the patch is seen in every case. The enlargement is a consequence of tension at the pedicle. After 15 months no morphological changes were observed at the patch nor were there any irregularities in liver function.

Ampulla of Vater↗
PubMed1991

[Perforation in Crohn disease as a complication in pregnancy].

The manifestation of Crohn's disease with perforation in pregnancy has been described in one case only. In our case, a 25-year-old woman in the 28th week of pregnancy was admitted to our hospital with signs of an acute abdomen. Due to deterioration of the maternal and foetal situation, the child was delivered by a Caesarean section. Subsequently, exploration of the abdomen showed an ileum perforation with diffuse fibrinous peritonitis. In this case, the definitive diagnosis could not be made prior to laparotomy. The aim of surgical therapy in such cases should be the limited resection with end to end anastomosis. In diffuse peritonitis, discontinuous resection and secondary reconstruction after three to six months is preferred.

Abdomen, Acute↗
PubMed1991

[Image analysis of DNA cytometry for assessing prognosis after resection of esophageal cancer].

Esophagus cancer is a heterogeneous disease with considerable differences in malignant behaviour. Some relevant factors for prognosis are known. In this study we analyzed DNA-ploidy as a potential prognostic parameter in esophagus carcinoma. Paraffin embedded histological material from 50 patients with an esophagus cancer, obtained by resection, were selected for analysis. Tumor areas within the paraffin material were identified by HE-stained reference sections. One 50 microns section was dewaxed, rehydrated and mechanically and enzymatically treated to a suspension of 10,000 cells/ml. 1 ml of the suspension, containing bare nuclei with small rests of cytoplasma was centrifuged on glass slides. The fixed nuclei were air-dried and stained by Feulgen-SITS technique, which allows quantitative measurement of DNA. The DNA analysis was carried out with a computer-controlled single cell cytophotometry (Leytas 2, Leitz, Wetzlar). In contrast to the flow cytometry with image cytometry only tumors cells were measured. Overlapping nuclei, dirt and other artefacts as well as inflammatory cells were efficiently eliminated. With the DNA image cytometry we could differentiate between diploid and hypotriploid, hypertriploid aneuploid tumors. Best prognosis had diploid and hypotriploid tumors, the worst hypertriploid carcinomas. In the multivariate analysis the DNA-content of the tumor cells in esophagus cancer was the only prognostic parameter. DNA-content of tumor cells may become considerably clinical relevant in esophagus cancer for the decision to perform a resection or palliative treatment. In patients with hypertriploid tumors an adjuvant oncological therapy may increase the prognosis.

Adenocarcinoma↗
PubMed1991

[Image analytic DNA cytometry--a possibility for assessment of prognosis after resection of ductal pancreatic cancers?].

In this study we analysed DNA-ploidy as a potential prognostic parameter in ductal pancreatic carcinoma. Paraffin embedded histological material, obtained by resection from 34 patients with a ductal pancreatic carcinoma, was selected for analysis. Tumor areas within the paraffin embedded material were identified by HE-stained reference sections. One 50 microns section was dewaxed, rehydrated and mechanically and enzymatically prepared to form a suspension of 10000 cells/ml. One milliliter of the suspension, which contained bare nuclei with small rests of cytoplasma, was centrifuged on glass slides. The fixed nuclei were air-dried and stained by Feulgen SITS technique, which allows for the quantitative measurement of DNA. The DNA analysis was carried out with a computer-controlled single-cell cytophotometry. In contrast to using flow cytometry, only the tumor cells were measured by image-cytometry. Overlapping nuclei, dirt and other artifacts as well as inflammatory cells were efficiently eliminated. With DNA image-cytometry, we could differentiate between hypotriploid, triploid, hypertriploid and tetraploid tumors. The DNA-content provided the strongest influence on prognosis in the multivariate analysis.

Carcinoma, Intraductal, Noninfiltrating↗
PubMed1991

Long-term results after surgical treatment of iatrogenic injury of the bile ducts.

To find out the long term results of repair of iatrogenic bile duct injuries we carried out a retrospective analysis of 111 patients treated at the General and Abdominal Surgery clinics of the Johannes Gutenberg-University of Mainz between 1 January 1964 and 31 December 1987. In 72 of the 111 patients (65%) reliable data were obtained about the course of the disease over a mean period of 9.4 years. Long term results depended on the site of the stenosis, and the number and type of operations. The number of operations depended on whether the injury was immediately recognised, and was higher in this type of repair.

Adolescent↗
PubMed1991

[Results of surgical therapy of cervical diverticulum].

Eighteen patients with a pharyngoesophageal diverticulum were operated on at the University Department of Surgery, Mainz, between September 1985 and July 1990. Results are based on follow-up studies of 15 patients. Three patients were operated upon less than six months ago. All patients underwent excision of the diverticulum and a cricopharyngeal myotomy. The mean age was 69 (49-84) years and the average follow-up interval was 30 (6-52) months. Twelve of the fifteen patients are free of symptoms concerning the esophagus since the operation. Two patients who died 17 resp. 22 months after the operation were also free of symptoms concerning the esophagus. In all 11 patients who had a barium contrast, swallowing was normal and no recurrence was found. The results show excision of the diverticulum combined with a cricopharyngeal myotomy to be an effective method with low risk for the long-term removal of pharyngoesophageal diverticulum.

Aged↗
PubMed1991

[Esophageal perforation--indications for surgical therapy].

From January 1, 1970 to April 1, 1990, we treated 32 patients with esophageal perforations. 19 patients underwent surgical repair by bilateral closing suture (n = 10), mucosal suture, extramyotomy and semifundoplication in the presence of achalasia (n = 6). Three patients had subtotal esophagus resection with esophageal graft. Four of these patients died postoperatively, the site of intervention being unremarkable. We lost 7 out of 13 patients from the group subjected to conservative therapy. These results suggest a low risk in the surgical treatment of esophageal perforations when carried out at early stage. The conservative approach on the other hand constitutes an uncalculable risk factor. It should be thus be employed with utmost precaution, e.g. in case of minor perforation only, or in patients with incurable carcinoma.

Adult↗
PubMed1991

[Results of endoscopic perforant vein dissection].

A new endoscopic technique allows insufficient perforating veins to be sectioned under direct visual control with minimal trauma. The endoscopical sectioning of perforating veins was performed on 61 patients in 86 legs. Perforating veins have most frequently been separated in the area of the Cockett group (185), the 24-cm perforating vein (74), and the Boyd group (63). Two patients showed disturbances of wound healing after the operation. By a follow-up examination 2 years postoperatively, insufficient perforating veins were not found in any of the 86 legs operated on. New varices were seen in six legs. With respect to a staging of chronic venous insufficiency, it can be said that in 90% of cases a more favorable stage or complete healing is reached.

Endoscopes↗
PubMed1991

[Local excision of early stages of rectal cancer].

59 patients with rectal cancer were treated by local excision. In 17 of these patients a radical resection was performed afterwards. In one of 21 local excised "low risk" T1-carcinomas a recurrence was observed. Five of 11 local treated patients with "high risk" tumours developed a recurrence. In the group of the radically treated patients two recurrences were seen. Regarding our results the local excision of "low risk" T1-carcinomas seems to be justified, if final histological workup reveals an adequate margin of healthy tissue.

Aged↗
PubMed1991

[Sensitivity of preoperative diagnosis in mesenteric vascular occlusion].

In a consecutive series the sensitivity of the preoperative diagnostic in acute mesenteric vascular occlusion was investigated prosprectively in 62 patients. 22 patients had an arterial thrombosis, 20 patients a venous thrombosis, 13 patients had an embolism, six patients a non-occlusive disease and one patient suffered from a dissection of the aorta. All but three patients (95.2%) had a leukocytosis with an average of 18,700/nl. The serum lactate was increased in 88.7% of the patients. The percutaneous ultrasonography was without any pathological findings in 45% of the patients. The x-ray of the abdomen shows signs of an ileus in more than half of the patients. The angiography had a sensitivity of 74%.

Aged↗
PubMed1991

[Endosonography versus computerized tomography in preoperative staging of esophageal cancers].

The results of endosonography and computed tomography--using an optimized technique of CT--in preoperative staging of esophageal cancer are compared. In 22 of 40 patients with esophageal tumors a complete passage by the ultrasonic endoscope was possible. Endosonography was superior to CT in the assessment of early stages of esophageal tumors (T1/T2). Out of nine tumors confined to the esophageal wall, eight were classified correctly by endosonography, only five by computed tomography. The results in T3- and T4-carcinomas (13 patients) were comparable for endosonography and computed tomography. Endosonography is of importance in the selection of patients with early stages of cancer, in whom a curative resectability is still possible.

Esophageal Neoplasms↗
PubMed1991

[Results of endoscopic perforating vein dissection].

The subfascial discision of insufficient perforating veins is considered the most effective therapeutic principle for the treatment of postthrombotic disturbances of the skin as well as for trophic disturbances caused by varicose. A new endoscopic technique allows to be sectioned them under direct view control with little trauma. In the period from November 1986 to April 1990 61 patients underwent an endoscopic sectioning of perforating veins. Perforating veins have most frequently been separated in the area of the Cockett group (153), the 24 cm perforating vein (74) and in the area of the Boyd group (63). Two patients (3.3%) with trophic disturbances of the skin in the area of the shank showed disturbances of wound healing after the operation. First results of the follow-up examination 3-37 months postoperative have proved good (45%) to very good (40%) results. Criteria, which were observed, were pains in the leg, disturbances of sensibility, swellings and relapsed varices. Only two patients proved a bad result. Insufficient perforating veins in the area of the shank were not found by one of the 61 operated patients. Referring to a staging of chronic venous insufficiency it can be said that with the exception of the two patients above mentioned there is a ranging to a more favourable stage or to a complete treating.

Adult↗
PubMed1991

[Endosonographic staging of cancers of the esophagus and stomach. Comparison with surgical and histopathologic staging].

64 patients (38 with esophageal and 26 with gastric carcinoma) underwent a preoperative endosonography. In 21 patients with esophageal tumors and in 24 patients with gastric tumors a complete endosonographic examination was performed. In 16 of 21 patients (76%) with esophageal carcinoma the tumor infiltration (T-stage), and in 16 of 18 cases (89%) the lymph node metastases (N-stage) could be assessed accurately. The depth of infiltration of cardia and gastric carcinoma was recognized in 15 of 19 cases (79%), and in 13 of 18 patients (72%) the N-stage was evaluated. Endosonography represents a method which can accurately predict tumor infiltration and regional lymph node metastases.

Endoscopes, Gastrointestinal↗
PubMed1990

[Intrarectal ultrasonography in the preoperative assessment of the depth of infiltration of rectal tumors].

From June 1987 to February 1990, 142 out of 319 patients with rectal tumours were investigated by ultrasound scanning with the object of ascertaining the depth to which the tumour had infiltrated. This examination proved completely feasible in 130 of these patients (84 men, 46 women, mean age 61.7 [42-84] years). Postoperative histological examination revealed an adenoma (n = 59) or a T1 carcinoma (n = 19), while intrarectal ultrasonography disclosed the same findings in 79 patients (true-positive in 75 cases). A T2-tumour was diagnosed by histological examination in 24 patients, and by ultrasonography in 22 (true-positive in 18 cases). The histological diagnosis of a tumour in stage T3 or T4 (n = 27) was in close agreement with the ultrasound findings (n = 24). The positive predictive value of ultrasonography ranged between 0.94 and 0.97 depending on the staging of the tumour, and the sensitivity between 0.75 and 0.96. Preoperative ultrasonographic determination of the depth of invasion of a rectal tumour enables the surgeon to devise a therapeutic plan to suit the individual patient's needs; one option may be local excision.

Adenoma↗
PubMed1990

[The early recurrence of Crohn's disease after "curative" ileocecal resection. A prospective endoscopic and histological study].

The postoperative course of 44 patients (24 women, 20 men; mean age 31.5 [18-63] years) treated by ileocaecal resection for Crohn's disease was investigated prospectively. None of the patients received any prophylactic drug treatment during the 12-month postoperative period of observation. Recurrence of Crohn's disease was endoscopically diagnosed in 21 of the 44 patients during the 12-month period, and in 14 patients recurrence was suspected. Histological confirmation of recurrent Crohn's disease, however, was obtained unequivocally in only 11 patients, while in further 20 patients there was suspicion of recurrence. A large proportion of the recurrences was already confirmed endoscopically and histologically by the end of the third postoperative month. It is concluded that recurrences are frequent and early after a "curative" operation, raising the question of early prophylaxis with drugs.

Adolescent↗
PubMed1990

[The value of preoperative diagnosis for surgical treatment of liver tumor. Results of a consecutive study series from the surgical viewpoint].

Value of preoperative diagnostic procedures in the surgical treatment of liver tumors. Results of a consecutive examination series from surgical view. Between September 1985 and December 1988 93 patients with tumors of the liver were operated at the University Hospital of Mainz. Most of them had metastases of colorectal cancer. The accuracy of preoperative diagnostic proceedings was very high using abdominal ultrasonography and computed tomography. The sensitivity of both methods for detecting a tumor amounts 88 and 95%. In spite of this high accuracy the intraoperative findings were different in 29% of the treated patients. An unfavourable intraoperative situation did not exclude a radical resection of the tumor. Therefore we think that the indication to operation is correct if there is any doubt about the expansion of the tumor.

Adenoma, Bile Duct↗